Retrospective study of risk factors for mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014

Cheng, Qinglin; Ding, Hua; Zhou, Sun; Kao, Qingjun; Yang, X. B.; Huang, Ren-Jie; Wen, Yuanyuan; Wang, Jing; Xie, Li

doi:10.1016/j.ijid.2015.09.008

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…Activation of the complement system has been implicated in the development of acute lung diseases induced by highly pathogenic influenza viruses ( Garcia et al, 2013 , Sun et al, 2013 , Sun et al, 2015 ). Recent studies have brought up the idea of CRP to be not only a systemic marker of inflammation but also a mediator in inflammation faci ( Thiele et al, 2015 ), and indicated that high levels of CRP is a high risk factor of fatality in H7N9 patients ( Cheng et al, 2015 , Wu et al, 2016 ). However, its exact physiological roles remain largely unknown, especially in severe influenza diseases.…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein Mediating Immunopathological Lesions: A Potential Treatment Option for Severe Influenza A Diseases

et al. 2017

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Severe influenza diseases with high mortality have been frequently reported, especially in those patients infected with avian influenza A (H5N1, H7N9 or H10N8) or during a pandemic. Respiratory distress, which is attributed to alveolar damage associated with immunopathological lesions, is the most common cause of death. There is a wealth of information on pathogenesis or treatment options. In this study, we showed that high levels of C-reactive protein (CRP) were induced and correlated with complement activation in patients infected with severe influenza A (H5N1, H7N9 or H10N8), and higher levels were induced in fatal patients than in survivors. CRP treatment enhanced the phagocytosis of monocytes THP-1 to H5N1 virus as well as the expression of proinflammatory cytokines or apoptosis-associated genes in THP-1 cells or pneumocytes A-549 respectively. CRP may link to proinflammatory mediators contributing to activation of complement and boosting inflammatory response in severe influenza infections. Compound 1,6-bis(phosphocholine)-hexane improved the severity and mortality of mice infected with lethal influenza virus significantly. These observations showed that CRP is involved in deterioration of severe influenza diseases, and indicated a substantial candidate molecule for immunotherapy of severe influenza diseases.

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Section: Introductionmentioning

confidence: 99%

C-Reactive Protein Mediating Immunopathological Lesions: A Potential Treatment Option for Severe Influenza A Diseases

et al. 2017

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“…Research has indicated that a high viral load is associated with illness severity and prognosis, 24 which might have originated from poor hand hygiene and self-protection measures after contact with poultry or other animals. 13,25 To improve the survival of H7N9 VI, it is vital that appropriate hand hygiene practices are implemented by the susceptible population after direct contact with poultry or birds. Furthermore, it can be inferred that PHH is associated with a nonlinear effect on the survival of H7N9 patients (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the investigators present their results with 95% confidence interval (CI), Z 0:05 =1.96 (α= 0.05), Z 0:10 =1.64 (β= 0.10), r = 2, p 0 = 35.3%, and OR= 2.5. 13 In addition, considering the loss of follow-up, participants' rejection rate, and sampling error, the final sample size was determined to be 200 in the training set. The validation set was selected in this study using the 'all comers' design.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…The way of all data collection has been detailedly described in the previous study. 13 All data were entered in duplicate into an electronic database. We retrospectively studied 227 laboratory-confirmed cases of H7N9 VI in Zhejiang Province from March 1, 2013, to May 31, 2019 (no new cases of H7N9 VI were reported in Zhejiang province after December 31, 2017).…”

Section: Data Collectionmentioning

confidence: 99%

“…Definitions of case and exposure and laboratory examination for the A (H7N9) virus have been detailedly described elsewhere. 13 The main outcome variable was measured as incident death or survival. Table 1 shows the definition of variables in this study.…”

Section: Variables and Definitionsmentioning

confidence: 99%

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<p>Nomogram for the Individualized Prediction of Survival Among Patients with H7N9 Infection</p>

Cheng

Zhou

Zhao

et al. 2020

RMHP

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These authors contributed equally to this work Background: Until recently, almost all of these studies have identified multiple risk factors but did not offer practical instruments for routine use in predicting individualized survival in human H7N9 infection cases. The objective of this study is to create a practical instrument for use in predicting an individualized survival probability of H7N9 patients. Methods: A matched case-control study (1:2 ratios) was performed in Zhejiang Province between 2013 and 2019. We reviewed specific factors and outcomes regarding patients with H7N9 virus infection (VI) to determine relationships and developed a nomogram to calculate individualized survival probability. This tool was used to predict each individual patient's probability of survival based on results obtained from the multivariable Cox proportional hazard regression analysis. Results: We examined 227 patients with H7N9 VI enrolled in our study. Stepwise selection was applied to the data, which resulted in a final model with 8 independent predictors [including initial PaO 2 /FiO 2 ratio ≤300 mmHg, age ≥60 years, chronic diseases, poor hand hygiene, time from illness onset to the first medical visit, incubation period ≤5 days, peak C-reactive protein ≥120 mg/L], and initial bilateral lung infection. The concordance index of this nomogram was 0.802 [95% confidence interval (CI): 0.694-0.901] and 0.793 (95% CI: 0.611-0.952) for the training and validation sets, respectively, which indicates adequate discriminatory power. The calibration curves for the survival showed optimal agreement between nomogram prediction and actual observation in the training and validation sets, respectively. Conclusion: We established and validated a novel nomogram that can accurately predict the survival probability of patients with H7N9 VI. This nomogram can serve an important role in counseling patients with H7N9 VI and guide treatment decisions.

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Avian Influenza: A Potential Threat to Human Health

Kumari¹,

Mavi

Kumar

et al. 2023

Emerging Human Viral Diseases, Volume I

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Retrospective study of risk factors for mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014

Abstract: Improvements in immunity, early case identification and treatment, and personal protection measures are key to addressing the high human avian influenza A(H7N9) case fatality rate.

Cited by 12 publications

References 22 publications

C-Reactive Protein Mediating Immunopathological Lesions: A Potential Treatment Option for Severe Influenza A Diseases

C-Reactive Protein Mediating Immunopathological Lesions: A Potential Treatment Option for Severe Influenza A Diseases

<p>Nomogram for the Individualized Prediction of Survival Among Patients with H7N9 Infection</p>

Avian Influenza: A Potential Threat to Human Health

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